Reasons to Treat Bipolar Disorder

Medically Reviewed By William C. Lloyd III, MD, FACS
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Bipolar disorder is a mental health condition that affects about 7 million people in the United States, roughly 2.8% of the population. Bipolar disorder is hard to diagnose, so some people with the disorder do not receive treatment. However, even after diagnosis, some people stop their treatment because they decide they do not need it anymore, or because medication side effects are distressing.

This means that many people with bipolar disorder go untreated, risking serious consequences to their overall health.

The effects of untreated bipolar disorder

As with many other health conditions, bipolar disorder can worsen if it goes untreated. With bipolar disorder, delays in diagnosis and treatment can lead to personal, social and financial problems because symptoms can include mood swings and risk-taking behaviors.

Some effects of untreated bipolar disorder may include:

  • Loss of ability to work: Bipolar disorder is the sixth leading cause of disability in the world.

  • Stress on personal relationships: This can result in unemployment, divorce, and legal problems.

  • Substance misuse issues: Delayed diagnosis may contribute to people with bipolar disorder misusing drugs and alcohol. Studies show that 56% of people with bipolar disorder misuse drugs and 44% misuse alcohol.

  • Suicide: Thirty percent of people with untreated bipolar disorder take their own lives.

Why bipolar disorder is hard to recognize

Most people who are eventually diagnosed with bipolar disorder—about 70%—are misdiagnosed at least once before the condition is identified. The average length of time from symptom onset to a correct diagnosis is 10 years.

Bipolar I disorder is the most common type. Once called manic depressive disorder, bipolar I involves mood swings from extreme highs (mania) to extreme lows (depression).

Bipolar II disorder involves severe depression, but the manic moods, called hypomania, are less intense and frequent than manic episodes. This type of bipolar disorder is often not recognized by primary care doctors, largely because hypomania is hard to spot.

Hypomania has some of the same characteristics as mania, but it does not last as long (4 days compared to at least a week for mania). In addition, it is not accompanied by major disruptions to your social or work life. In fact, some people view hypomania in a positive light. A hypomanic person may be the “life of the party,” always coming up with new ideas and not needing much sleep.

Other reasons for misdiagnosed bipolar disorder include:

  • Many people with mania, especially hypomania, do not recognize it as abnormal. They may think of it as simply a high amount of energy or joy.

  • People may have more depression than mania and may be misdiagnosed as having major depression.

  • People in a severe manic episode may see, hear or believe things that are not real and be misdiagnosed as having schizophrenia.

  • Nearly 60% of people with bipolar disorder also misuse drugs or alcohol, and bipolar disorder is sometimes misdiagnosed as substance use disorder.

  • In children and adolescents with bipolar disorder, the symptoms may be misdiagnosed as ADHD (attention deficit hyperactivity disorder).

Getting diagnosed and treated

While bipolar disorder is generally a lifelong illness, treatment helps most people manage their symptoms. Even with treatment, you may have some lingering symptoms and relapses, but the overall incidence of disruptive symptoms should decrease.

Because there is no blood test or brain scan that can diagnose bipolar disorder, let your doctor know if you have any of the symptoms. You may be at increased risk of bipolar disorder if you have a family history of the disorder.

Symptoms to report include:

  • Periods of depression during which you may be very tired, lack energy, be unable to think straight, feel helpless, or have thoughts of death or suicide

  • Periods of mania during which you may not need sleep and may talk very fast, be very restless, have unrealistic ideas, and engage in reckless behaviors

  • Periods of mania or depression that last for at least 7 days

  • Periods of mania or depression that are a major change from your normal behavior, most likely affecting your work and social life

  • Shifting back and forth between periods of feeling low, sad and helpless and feeling high, unstoppable and energetic

Key takeaways

  • Bipolar disorder is a mental health condition that often goes undiagnosed, misdiagnosed and untreated.

  • It may be confused with many other mental and behavioral disorders.

  • Untreated bipolar disorder can lead to social, emotional and financial problems as well as substance misuse and suicide.

  • Early diagnosis and treatment will help you manage your symptoms more effectively.

Was this helpful?
  1. Goodwin G. Hypomania: what’s in a name? The British Journal of Psychiatry. 2002;181:94-5.
  2. Bipolar Disorder. National Alliance on Mental Illness.
  3. Mental Health by the Numbers. National Alliance on Mental Illness
  4. Bipolar Disorder. University of Maryland Medical Center.
Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Jul 8
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